Treasury Pulls the Strings at “Fixing NHS Dentistry Hearings”
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- Published: Tuesday, 18 February 2025 19:15
- Written by Peter Ingle
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From time to time there have been hopes of a revival in the fortunes of NHS dentistry. There was the promise of extra money that did not turn up. The promise of a ring fence to retain the existing funds, that turned out to be full of gaps.
The recovery plan from a government that knew it would not be around to see if it worked. The 700,000 extra appointments that have yet to appear. And, the select committees.
Which leads to the Public Accounts Committee (PAC). As covered in GDPUK they have set up an inquiry called ‘Fixing NHS dentistry.’ Now it has completed its evidence gathering, it might be time consider its chances of achieving that ambitious aim.
When the inquiry was announced, Shawn Charlwood, then Chair of the British Dental Association’s General Dental Practice Committee observed that NHS dentistry was not in peril due to a lack of parliamentary committees, saying: “The Health Committee provided an instruction manual to save this service. What’s remained missing to date is the sustainable funding to deliver it.”
As the PAC met to gather oral evidence the BDA made its feelings clear, and pointed out that NHS provision was now being kept afloat by a cross-subsidy from private work worth at least £332m a year. They warned the Committee that time and again the Treasury has stifled reform, and limited change to modest recycling of unsustainable budgets. The BDA pointedly added that this toxic culture remained in place despite the change in government.
Even more of a change from their initial all smiles meetings with the new government were the BDA comments about the Chancellor and her budget. They said, “Dentists leaders are now wary that the new leadership at the Treasury,” would continue with the Conservatives gradual shift to funding NHS care from patient charges.
As for the much vaunted growth budget: “The recent budget has brought service to its lowest ebb. This modelling was undertaken before the autumn budget added millions in new costs – via both National Insurance and National Minimum Wage increases – which will hit on 1 April with no mitigations in place. Dentists have just been offered a real cut in pay after the failure to cover the soaring costs of delivering NHS care.” The BDA estimated that the budget would increase the Private to NHS cross subsidy to £425 million.
The Committee chose five key figures to give oral evidence:
- Sir Chris Whitty Acting Permanent Secretary at Department of Health and Social Care
- Jonathan Marron CB Director General - Primary Care and Prevention at Department of Health and Social Care
- Amanda Pritchard Chief Executive at NHS England
- Jason Wong MBE Chief Dental Officer England at NHS England & DHSC
- Ali Sparke Director for Pharmacy, Optometry, Dentistry at NHS England
GDPUK must admit to knowing little about Jonathan Marron but the other names come with some baggage and strong links to the previous regimes both at the Department of Health and Social Care, NHS England, and the Office of the Chief Dental Officer.
It seemed unlikely that they would bring much fresh thinking to the Committee, and soon after the hearing was over there was a downbeat assessment from the BDA.
They, “mourned the scenes at today’s Public Accounts Committee inquiry into dentistry” and the Committee had heard “Treasury talking points” but there was no plan to save the service. All of the parties giving evidence lacked the autonomy to deliver on the government’s manifesto pledges to rebuild NHS dentistry, including the promise to reform the long discredited UDA based contract. Officials may have spoken of commissioning ‘additional activity’, but neatly sidestepped any talk of new investment. In a moment of clarity, Ali Sparke, Director for Pharmacy, Optometry, Dentistry, at NHS England had acknowledged that, “there just isn’t enough dentistry commissioned full stop… we know there is only enough funding for 50 per cent of the population.”
Officials had “fudged” their answers to calls from the Committee for an official assessment of the real costs of providing care. During evidence NHS England CEO Amanda Pritchard acknowledged the past Government’s Recovery Plan was ‘not successful’ and the modelling behind it was fundamentally flawed. Indeed back In March 2024 former Minister Andrea Leadsom admitted the modelling, “had a quite high likelihood of not being reliable.”
Shiv Pabary, the newly elected Chair of the British Dental Association’s General Dental Practice Committee, said: “The people that could give NHS dentistry a future didn’t give evidence today, but their Treasury talking points were there for all to hear. Until the accountants step aside, health ministers and their most senior officials will not have the headroom to save this service.”
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